Radicular cysts are the most common cystic lesions that affect the jaws, which, though mostly asymptomatic, can be seen radiographically as an oval or pear-shaped unilocular radiolucency in the periapical region. Nonsurgical root canal procedures and periapical surgery followed by placement of bone substitute and bioceramic root-end filling material is generally the treatment of choice. This case report highlights the endosurgical management of long-standing trauma that led to a radicular cyst with respect to three maxillary anterior teeth in a young adult. The clinical and radiographic examination led to a provisional diagnosis of a radicular cyst, which was confirmed by biopsy. Non-surgical root canal treatment was performed with Mineral Trioxide Aggregate (MTA) as the apical barrier and surgical enucleation of the cyst was performed followed by placement of hydroxyapatite bone graft. Follow-ups till two years were done, which revealed the successful management of the case.

To prevent re-infection and provide a hermetic seal of the root canal system, an endodontist must aim to produce a void-free obturation. This review aimed to compare the completeness of root canal obturation between the two most prevalent methods-cold lateral condensation and warm gutta-percha techniques-using micro-CT (PROSPERO reg no. 249815).
METHODS: A search of Scopus, Embase, PubMed (Medline via PubMed), and Web of Science databases was done without any time restriction according to the PRISMA protocol. Articles that compared both techniques and were published in English were included. Data was extracted and the risk of bias was assessed using an adapted tool based on previous studies.
RESULTS: A total of 141 studies were identified by the search. Following the screening and selection of articles, 9 studies were included for review. Data was extracted manually and tabulated. Most studies had a moderate risk of bias. None determined operator skill in both methods before comparison. The data extracted from the included studies suggests that both techniques produce voids in the obturation. The thermoplasticized gutta-percha techniques may result in fewer voids compared to cold lateral condensation.
CONCLUSIONS: Considering the limitations of the included studies, it was concluded that neither technique could completely obturate the root canal. Thermoplasticized gutta-percha techniques showed better outcomes despite a possible learning bias in favor of cold lateral condensation. Establishing operator skills before comparison may help reduce this bias.

To evaluate the fill of internal resorption cavities obturated with thermoplasticized gutta-percha and GuttaFlow2 using CT scan. Twenty human maxillary anterior teeth were selected and root canals were prepared using ProTaper system to size F3. Irrigation was performed with 5 ml of 2.5% sodium hypochlorite (NaOCl) and 5 ml of 17% ethylenediaminetetraacetic acid (EDTA). Each root was then sectioned horizontally into two halves and semicircular cavities were prepared around the periphery of the root canal opening of each root half, using a round bur. Both the root halves were then fixed using cyanoacrylate glue. All the specimens were subjected to preoperative CT scan analysis to determine the volume of internal cavities. The samples were then randomly divided into two groups. In Group 1, the specimens were obturated with thermoplasticized gutta-percha (E&Q system) and specimens in Group 2 were obturated using GuttaFlow2. All specimens were then subjected to postoperative CT scan analysis. The volume of voids in internal resorptive cavities were calculated, which was then used to estimate the amount of gutta-percha filled. There was no significant difference in volume of internal resorptive cavities between thermoplasticized gutta-percha and GuttaFlow2 groups before obturation (p = 0.466). However, after obturation there was a significant difference between both the groups, in which GuttaFlow2 demonstrated better fill (p = .014). Thermoplasticized gutta-percha filled 81% of internal resorptive cavity while GuttaFlow2 filled 91%, respectively. GuttaFlow2 showed better fill than thermoplasticized gutta-percha in the filling of internal resorptive cavities.

BACKGROUND: This study had 2 purposes: to compare the Microseal, continuous wave, and Thermafil techniques and to compare the same techniques with and without endodontic sealer.
METHODS: Ninety extracted mandibular premolars were allocated into 6 groups obturated with Microseal (Analytic, Glendora, CA) and sealer (Mseal), Microseal without sealer (Mnoseal), System B (EIE Analytic Technology, Orange, CA) and sealer (SBseal), System B without sealer (SBnoseal), Thermafil (Dentsply, Tulsa Dental, Tulsa, OK) and sealer (Tseal), and (Tnoseal) Thermafil without sealer (Tnoseal). The teeth were sectioned at 1 and 3 mm from the apex. The total area of each canal segment was measured, and the areas were converted to the percentage of gutta-percha-filled areas, sealer-filled areas, and void areas. Data obtained were statistically elaborated using the t test (P ≤ .01).
RESULTS: At 1 mm, SBseal produced a higher VA than Mseal and Tseal. At 3 mm, Tseal produced a lower VA than Mseal and SBseal, whereas Mseal produced a lower VA than SBseal (P > .01). At 1 mm, Tnoseal produced a significantly higher VA than Mnoseal and SBnoseal (P = .001). At 3 mm, Tnoseal produced a higher VA than Mnoseal and SBnoseal (P = .01). Tnoseal produced a significantly higher VA than Tseal both at 1 mm (P = .001) and 3 mm (P = .001).
CONCLUSIONS: Endodontic space filling is traditionally provided by sealer and gutta-percha. In this study\'s conditions, gutta-percha alone showed better filling at both 3 mm and 1 mm in the Microseal and System B techniques. Considering the limits of our study, we can affirm that endodontic techniques using sealer could counteract thermoplasticized gutta-percha progression.

OBJECTIVE: To investigate and compare the fracture resistance of resilon and realseal filled root canals with those that were obturated with thermoplasticized gutta-percha and AH-plus endodontic sealer.
METHODS: Eighty extracted human mandibular single-rooted premolars stored in 10% formalin were used in this study. They were prepared by using a crown-down technique, debrided and irrigated with NaOCl, EDTA, and normal saline and divided into four groups. Group I = Negative control, canals prepared but no obturation was done; Group II = Positive control obturated with dual cure composite resin; Group III = Obturated with thermoplasticized GP and AH-plus; Group IV = Obturated with resilon and realseal. All root specimens were stored for two weeks in 100% humidity to allow for complete setting of the sealer. Each specimen was mounted in acrylic in a polyvinyl ring and tested for fracture resistance with a universal testing machine. The loading fixture of the machine was mounted with its spherical tip aligned with the center of the access opening of each root. A vertical loading force was applied until it fractured the root. The force values were subjected to statistical analysis: Kruskall-Wallis H-test and Mann-Whitney U-test.
RESULTS: Group comparison revealed that Group II (positive control) had significantly higher values of resistance to fracture as compared to all the other groups. While Group IV (resilon with realseal) had significantly higher values of resistance to fracture as compared to Group I (negative control).
CONCLUSIONS: On the basis of our findings, it can be concluded that filling the root canals with resilon and realseal increased the in vitro resistance to fracture of single-canal extracted teeth. resilon and realseal demonstrated high fracture-resistance values and could be an alternative to the conventional gutta-percha.

OBJECTIVE: To assess the percentage volumes of filling materials and voids in oval-shaped canals filled with either cold lateral compaction or warm compaction techniques, using micro-computed tomography (micro-CT).
METHODS: Twenty-four single-rooted maxillary premolar teeth with oval-shaped canals were selected and the root canals prepared and assigned to two groups (n = 12), according to the filling technique: cold lateral compaction (CLC) or warm vertical compaction (WVC). Each specimen was scanned using a micro-CT device at an isotropic resolution of 12.5 μm. Percentage volumes of root filling materials and voids were calculated, and data were statistically analysed using Student\'s t-test and Friedman\'s test, with a significance level of 5%.
RESULTS: Overall, mean percentage volumes of gutta-percha, sealer and voids were 82.33 ± 3.14, 13.42 ± 2.91 and 4.26 ± 0.74 in the CLC group and 91.73 ± 4.48, 7.70 ± 4.44 and 0.57 ± 0.44 in the WVC group, respectively, with a statistically significant difference between groups (P < 0.05). At the apical level, differences in the percentage volumes of filling materials and voids between groups were not significant (P > 0.05).
CONCLUSIONS: No root fillings were void free. Warm vertical compaction produced a significantly greater volume of gutta-percha and a significantly lower percentage of voids than those achieved with cold lateral compaction. Distribution of sealer and voids within the root canal space after root filling was unpredictable, irrespective of the technique used.

OBJECTIVE: The purpose of this study was to evaluate the adequacy of three obturation techniques namely lateral condensation, EQ Fil (backfill obturation) and thermafil (core carrier obturation) techniques using three-dimensional (3D) helical computed tomography (CT) by volume rendering method.
METHODS: Thirty freshly extracted teeth were randomly divided into three groups of 10 teeth each. Biomechanical preparation was done in all the teeth using rotary instruments. All three sets of teeth were placed in helical CT slice scanner and were imaged before obturation. The three sets were then obturated by following methods: Group I: lateral condensation, Group II: EQ Fil (backfill) and Group III: thermafil (core carrier obturation).Volume of the pulp chamber and gutta-percha after obturation were calculated using volume rendering technique and adequacy of the obturation techniques were calculated.
METHODS: One-way ANOVA and Multiple-Range Tukey Test by Tukey-HSD procedure
RESULTS: Mean change in lateral condensation (0.005±0.002) was significantly higher than that of thermafil obturation (0.002±0.001) [P<0.05].
CONCLUSIONS: Conventional lateral condensation technique showed maximal inadequacy of obturation and thermafil obturation technique showed the least inadequacy of obturation when the volume of the specimens were calculated and reconstructed.

OBJECTIVE: To compare the laterally condensed gutta-percha, vertically compacted thermoplastized gutta-percha (E and Q Plus system) and cold free-flow gutta-percha (GuttaFlow). This is a volumetric analysis using spiral CT, an in vitro study.
METHODS: Access cavities were prepared in 60 single rooted anterior teeth; cleaning and shaping was done and obturated with three of the different techniques: group A: cold lateral; group B: vertically compacted thermoplasticized and group C: cold free-flow obturation techniques. Volume analysis was done using spiral computed tomography (CT). The percentage difference was calculated and statistically analyzed using one-way ANOVA and post hoc multiple comparison Tukey HSD tests.
RESULTS: There were statistical significant differences between group A (0.183cm(3)) and group B (0.136cm(3)); group A (0.183cm(3)) and group C (0.128cm(3)). But there was no statistical significance between group B (0.136cm(3)) and group C (0.128cm(3)).
CONCLUSIONS: Within the limitations of this in vitro study it can be concluded that cold free-flow obturation technique showed the highest volume of obturation, followed by the vertically condensed thermoplasticized technique. The least volume of obturation was observed in cold lateral condensation technique.